Deandra L Clark, MS, LCPC-C, LADC is a
Social Worker based in Portland, Maine. Deandra L Clark is licensed to practice in Maine (license number LS6308) and her current practice location is
250 Anderson St, Portland, Maine. She can be reached at her office (for appointments etc.) via phone at
(207) 775-5671.
NPI number for Deandra L Clark is 1588713655 and her current mailing address is Po Box 8264, Portland, Maine. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1588713655.
Healthcare Provider's Profile
| Full Name | Deandra L Clark |
|---|
| Gender | Female |
|---|
| Speciality | Social Worker |
|---|
| Location | 250 Anderson St, Portland, Maine |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1588713655
- Provider Enumeration Date: 01/09/2007
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Deandra L Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1588713655 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | LC3715 (Maine) | Primary |
| 101YM0800X | Counselor - Mental Health | XL2975 (Maine) | Primary |
| 104100000X | Social Worker | LS6308 (Maine) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Deandra L Clark is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Deandra L Clark, MS, LCPC-C, LADC
Po Box 8264,
Portland, ME 04104-8264
Ph: (207) 939-1909 | Deandra L Clark, MS, LCPC-C, LADC
250 Anderson St,
Portland, ME 04101-2545
Ph: (207) 775-5671 |
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